Typically, a care provider may only have a patient’s information captured during a single visit. Now, it’s only taking minutes to share comprehensive health data, run analytics and provide actionable, predictive insights that help providers deliver more informed care. And according to Ashok Chennuru, chief data and insights officer for Anthem, Inc., “That’s thanks to the power of machine learning, data-driven insights, and the cloud.”
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As a leading health benefits company dedicated to improving lives and communities, Anthem is using data, analytics, and machine learning (ML) in the cloud to make proactive, predictive, and personalized care possible for millions of consumers.
By building a centralized, secure data system on the cloud, and using advanced ML models to generate predictive insights, the health services company was able to automate processes such as claims payments and standardize data—fueling more informed care and better health outcomes.
Expanding consumer data infrastructure to innovate on the cloud
Legacy systems and siloed data repositories make it challenging for healthcare organizations to proactively respond to consumer needs. Anthem was one of the early players to realize that the ability to query health-related data, perform analytics, and run ML algorithms at the point of care has the potential to be life-saving.
Generating predictive patient insights with ML can help care providers make data-informed decisions on the best possible form of care for a person based on their claims history, genomic makeup, social determinants, and a number of other factors. Additionally, processing claims with analytics streamlines and better informs care. Providers know what’s covered within the person’s insurance policy—leading to faster, more personalized follow-up care recommendations.
But to achieve this level of data democratization and ML maturity at scale, Anthem first needed to modernize its data infrastructure. Anthem has one of the largest data footprints in the country, processing 20 billion claims a year and securely housing thousands of petabytes worth of individual and population clinical data, claims data, electronic health records (EHRs), and more. The company works with hundreds of thousands of physicians, hospital partners, employers, and government agencies to deliver high-quality healthcare services.
Until recently, all of Anthem’s data was housed in disparate systems. Transforming unstructured data, validating medical claims, and sharing data with care providers was difficult to achieve without added manual intervention.
“We had data in several repositories, and the data was very siloed. It was challenging to take advantage of our rich data sets,” said Chennuru. ”We had some analytics related to claims processing, but most of it was very traditional and not much ML. There was a lot of human intervention required.”
Anthem worked closely with AWS, to move petabytes of data to a HIPAA-compliant, secure, centralized data lake, leveraging Amazon S3, Amazon EMR, and Amazon SageMaker on the cloud. The data lake uses ML to standardize unstructured and structured data all in one place, making it easier for Anthem to ingest, process, and share data. And at the same time ensures that the data remains secure, and all privacy protections are intact.
“Our work with AWS is taking data out of silos and putting it in the hands of care providers and consumers. This enables shared decision-making, insights, and collaboration at all levels of care,” says Chennuru. “When healthcare professionals can spend less time wrangling the data, they can focus more on taking care of their patients.”
Anthem now has a single source of truth for its data. The center of data excellence enables the health company to automate many of its manual processes, freeing up valuable resources to focus on innovation and helping improve consumers’ health and wellbeing.
How Anthem leverages cloud as part of its efforts to drive proactive, predictive, and personalized healthcare
With a centralized, modern data store, Anthem was able to take advantage of more advanced technologies to help fuel higher quality health outcomes. By partnering with AWS for analytics, and ML services, the health benefits company has become more agile than ever and accomplished several important outcomes, including:
● Helping physicians predict patient outcomes with ML-driven insights.
With AWS ML and analytics tools, Anthem is able to help uncover relationships in data to discover trends and make precise predictions, like the effectiveness of certain medication for a given patient or how long recovery will take. This can be immediately communicated with the care provider team and even integrated into the patients’ electronic medical record (EMR).
“The biggest opportunity when you move to the cloud is getting access to new technologies,” according to Chennuru. “Using machine learning, we can take clinical information such as surgeries and claims history to help predict patient progression and better communicate with physicians at the moment of care.”
● Improved data access for better patient care:
An improved data infrastructure helped Anthem build Health OS, its comprehensive digital platform that shares medical information bidirectionally between payer and provider teams. Normally, physicians only have access to patient information captured on that particular visit, but with Anthem’s platform, care teams can easily access the entire patients’ medical history to provide more informed care.
“We work with care providers in 90% of the country in one form or another. By partnering with AWS, we have built pipes to send structured and unstructured data nationwide so physicians can have rich medical data at their fingertips for millions of consumers,” says Chennuru.
● Reduction in avoidable admissions
The scalability of AWS’ infrastructure helped Anthem efficiently increase coverage of admission, discharge, and transfer data from major networks on a near-real time basis. Using AWS ML and analytics tools to make use of this data, Anthem was able to accurately identify anomalies as unique situations. These Insights have allowed Anthem to implement predictive models and education programs that drastically reduce the occurrence of avoidable admissions within our network.
Key takeaways for business leaders scaling their data strategy
Data store, analytics, and ML services on the cloud can help companies across industries experience operational efficiencies and make better, more informed decisions. Organizations can follow these best practices from Anthem to build a data-driven organization:
- Ensure data quality and accuracy. Whether you’re in the medical room or the board room, ML-generated insights are only as accurate as the data provided. Be sure to invest in a high-quality, modern database management system that can standardize data to establish a single source of truth. “We’re dealing with large and complex data sets, so it’s important to focus on the quality and accuracy of the data so you can deliver on your goals, which, for us, is simplifying healthcare and helping consumers lead healthier lives,” says Chennuru.
- Invest in data literacy and proficiency. All stakeholders need to have the ability to understand, interpret, and have meaningful conversations about data. Anthem provides data literacy and proficiency training to ensure everyone—from its health advisors to its claim professionals—is able to work with data to drive better business outcomes.
- Make continuous improvements. Building accurate ML models takes time, so it’s important to establish with your team that learning is an essential part of the process. Anthem practices a framework called DIAL, which stands for data, insights, action, and learning. Chennuru describes the process further as a “continuous loop, where you start with the data, identify the insights you need, take action through development, and learn from the outcomes.”
Modernizing its data infrastructure allows Anthem to focus on innovation and enhancing the healthcare experience, rather than the undifferentiated heavy lifting that comes with self-managing infrastructure. New technologies are helping Anthem transform the healthcare industry, powering more proactive, personalized care and better health outcomes.
Learn more about how your organization can harness the power of data, ML, and the cloud.
